164 Participants Needed

MRI-Guided Prostate Boosts for Prostate Cancer

(BLaStM Trial)

PN
Overseen ByPavel Noa Hechavarria
Age: 18+
Sex: Male
Trial Phase: Academic
Sponsor: University of Miami
Must be taking: Anti-androgens
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

What is the purpose of this trial?

The purpose of this research study is to learn about: 1) improving control of prostate cancer using an extra high dose radiation treatment to the MRI defined high risk tumor areas, in addition to the standard radiation treatment to the rest of the prostate; 2) preserving quality of life by reducing dose to the nearby organs at risk around the prostate; and 3) establishing the relationship of pre- and post-treatment MRI to MRI-directed biopsy results at 2-2.5 years after treatment.

Do I need to stop my current medications for the trial?

The trial protocol does not specify if you need to stop your current medications. However, if you are on androgen deprivation therapy (ADT), there are specific guidelines you must follow. Please discuss with your doctor for more details.

Will I have to stop taking my current medications?

The trial protocol does not specify if you need to stop taking your current medications. However, if you are on androgen deprivation therapy (ADT), there are specific guidelines about its use during the trial.

What data supports the idea that MRI-Guided Prostate Boosts for Prostate Cancer is an effective treatment?

The available research shows that MRI-Guided Prostate Boosts, also known as Stereotactic Ablative Radiotherapy (SABR), is effective for treating prostate cancer, especially for low- and intermediate-risk patients. Studies indicate that SABR can deliver high doses of radiation with precision, similar to brachytherapy, but with fewer side effects. It is also less costly and uses fewer resources compared to other radiation techniques. While SABR is promising for high-risk patients, more data is needed before it can be widely recommended for them outside of clinical trials. Overall, SABR is a promising treatment option for prostate cancer, offering similar effectiveness to traditional methods with potential benefits in cost and side effects.12345

What data supports the effectiveness of the treatment MRI-Guided Prostate Boosts for Prostate Cancer?

Research shows that Stereotactic Ablative Body Radiotherapy (SABR), a component of the treatment, is promising for prostate cancer, offering similar effectiveness to brachytherapy with potentially fewer side effects. It is well-tolerated and may delay further treatment needs, although more studies are needed to confirm its long-term benefits.12345

What safety data exists for MRI-guided prostate boosts in prostate cancer treatment?

Stereotactic Ablative Radiotherapy (SABR) and its variants, such as Stereotactic Body Radiation Therapy (SBRT), have been studied for prostate cancer treatment. For low- and intermediate-risk patients, SABR has been compared to other radiotherapy methods in large randomized studies, showing it to be feasible and well-tolerated with careful planning. However, for high-risk patients, there is insufficient data to recommend its use outside clinical trials. Studies have shown that SABR is cost-effective and increases system capacity, with promising safety and efficacy results, especially when using advanced systems like CyberKnife. Long-term safety data at higher dose levels is still limited, but SABR is becoming a standard of care for low and intermediate-risk prostate cancer based on positive outcomes from various studies.15678

Is MRI-guided prostate boost treatment generally safe for humans?

Stereotactic Ablative Radiotherapy (SABR), a form of MRI-guided prostate boost treatment, has been shown to be well tolerated and feasible for prostate cancer with careful planning, although long-term safety data is limited.15678

Is the treatment HEIGHT RT, LEAD RT a promising treatment for prostate cancer?

Yes, HEIGHT RT, LEAD RT, which includes methods like Stereotactic Body Radiation Therapy (SBRT), is promising for treating prostate cancer. Studies show that using MRI guidance with this treatment can lead to better outcomes for patients. It helps doctors target the cancer more precisely, which can improve the effectiveness of the treatment and potentially reduce side effects.910111213

How is the MRI-Guided Prostate Boosts treatment different from other prostate cancer treatments?

This treatment uses MRI guidance to precisely target prostate cancer with high doses of radiation in fewer sessions, known as stereotactic body radiotherapy (SBRT). This approach can potentially improve treatment accuracy and outcomes compared to traditional methods, which often use more sessions with less precise imaging.910111213

Research Team

Alan Pollack MD PhD Miller School of ...

Alan Pollack, MD

Principal Investigator

University of Miami

Eligibility Criteria

Men aged 35-85 with confirmed prostate cancer (adenocarcinoma), T1-T3 stage, Gleason score 6-10, and PSA ≤100 ng/mL. No metastasis or previous radical prostate surgery/radiotherapy. Androgen deprivation therapy is allowed if decided before joining. Participants must be able to consent and willing to complete quality of life assessments.

Inclusion Criteria

My prostate cancer has a Gleason score between 6 and 10.
Suspicious peripheral zone or central gland lesion on MP-MRI
My prostate cancer is confirmed by biopsy.
See 8 more

Exclusion Criteria

I have a history of disorders related to lymphocyte proliferation.
I have a history of cancer.
I do not have any active cancer except for non-spreading skin cancer or early chronic lymphocytic leukemia.
See 4 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either HEIGHT or LEAD radiotherapy, consisting of 39 fractions over approximately 7.5 to 8 weeks

7.5-8 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment, including MRI-directed biopsy results at 2-2.5 years

Up to 5.25 years

Long-term Monitoring

Participants' health-related quality of life and other outcomes are assessed up to 5.25 years post-treatment

Up to 5.25 years

Treatment Details

Interventions

  • HEIGHT RT
  • LEAD RT
Trial OverviewThe study tests adding a high dose radiation treatment targeting MRI-defined high-risk tumor areas in the prostate, on top of standard radiation therapy, aiming to control cancer while sparing nearby organs from excess radiation.
Participant Groups
2Treatment groups
Experimental Treatment
Group I: LEAD RT GroupExperimental Treatment1 Intervention
Participants in this group will receive the Lattice Extreme Ablative Dose (LEAD) radiotherapy. Radiotherapy will begin within two months of fiducial marker placement. The therapy will consist of 39 fractions over approximately 8 weeks.
Group II: HEIGHT RT GroupExperimental Treatment1 Intervention
Participants in this group will receive the Hypofractionated Extended Image-Guided Highly Targeted (HEIGHT) radiotherapy. Radiotherapy will begin within two months of fiducial marker placement. The therapy will consist of 39 fractions over approximately 7 and a half weeks.

HEIGHT RT is already approved in European Union, United States, Canada for the following indications:

🇪🇺
Approved in European Union as SBRT for:
  • Prostate cancer
  • Lung cancer
  • Liver cancer
  • Pancreatic cancer
🇺🇸
Approved in United States as SBRT for:
  • Prostate cancer
  • Lung cancer
  • Liver cancer
  • Pancreatic cancer
🇨🇦
Approved in Canada as SBRT for:
  • Prostate cancer
  • Lung cancer
  • Liver cancer
  • Pancreatic cancer

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Miami

Lead Sponsor

Trials
976
Recruited
423,000+

Findings from Research

Stereotactic ablative radiotherapy (SABR) has been shown to be feasible and well tolerated for low- and intermediate-risk prostate cancer patients, with promising results from large randomized studies comparing it to conventional treatments.
While SABR shows potential benefits and cost-effectiveness, there is currently insufficient data to recommend its use for high-risk prostate cancer patients outside of clinical trials.
Stereotactic Ablative Body Radiotherapy for Intermediate- or High-Risk Prostate Cancer.Loblaw, A.[2021]
In a comparison of two treatment methods for high-risk prostate cancer, the SABR boost showed a significantly lower rate of biochemical failure (0%) compared to the HDR-BT boost (18.2%) over a median follow-up of 62 to 72 months, suggesting better efficacy for SABR.
Both treatment methods resulted in similar levels of acute and late toxicity, with minimal impact on quality of life, indicating that SABR may be a safe alternative to HDR-BT for patients undergoing pelvic radiation therapy and androgen deprivation therapy.
Gantry-Based 5-Fraction Elective Nodal Irradiation in Unfavorable-Risk Prostate Cancer: Outcomes From 2 Prospective Studies Comparing SABR Boost With MR Dose-Painted HDR Brachytherapy Boost.Musunuru, HB., Cheung, P., Vesprini, D., et al.[2022]
Stereotactic ablative body radiation (SABR) is a promising non-invasive treatment for localized prostate cancer, showing similar efficacy to brachytherapy in terms of disease control and lower side effects, making it a potentially safer option.
SABR is also more cost-effective and resource-efficient compared to traditional radiation techniques, but further well-powered studies are needed to confirm its benefits before it can be considered standard care, especially for patients with metastatic disease.
Stereotactic ablative body radiotherapy in patients with prostate cancer.Loblaw, A., Liu, S., Cheung, P.[2023]

References

Stereotactic Ablative Body Radiotherapy for Intermediate- or High-Risk Prostate Cancer. [2021]
Gantry-Based 5-Fraction Elective Nodal Irradiation in Unfavorable-Risk Prostate Cancer: Outcomes From 2 Prospective Studies Comparing SABR Boost With MR Dose-Painted HDR Brachytherapy Boost. [2022]
Stereotactic ablative body radiotherapy in patients with prostate cancer. [2023]
Dosimetric and patient correlates of quality of life after prostate stereotactic ablative radiotherapy. [2018]
Stereotactic ablative radiotherapy with CyberKnife in the treatment of locally advanced prostate cancer: preliminary results. [2017]
Treatment outcomes of postoperative ultra-hypofractionated stereotactic body radiotherapy in prostate cancer. [2023]
Dose-Intensified Stereotactic Ablative Radiation for Localized Prostate Cancer. [2022]
Evolution of hypofractionated accelerated radiotherapy for prostate cancer - the sunnybrook experience. [2022]
Outcome of the first 200 patients with prostate cancer treated with MRI-Linac at Assuta MC. [2023]
Magnetic resonance image-guided adaptive stereotactic body radiotherapy for prostate cancer: preliminary results of outcome and toxicity. [2022]
1.5T Magnetic Resonance-Guided Stereotactic Body Radiotherapy for Localized Prostate Cancer: Preliminary Clinical Results of Clinician- and Patient-Reported Outcomes. [2021]
12.United Statespubmed.ncbi.nlm.nih.gov
Magnetic Resonance Imaging-Guided vs Computed Tomography-Guided Stereotactic Body Radiotherapy for Prostate Cancer: The MIRAGE Randomized Clinical Trial. [2023]
Adaptive SBRT by 1.5 T MR-linac for prostate cancer: On the accuracy of dose delivery in view of the prolonged session time. [2021]